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Income Taxes - Reconciliation of Tax Rate (Details) - USD ($) $ in Thousands	12 Months Ended
	Dec. 31, 2021	Dec. 31, 2020	Dec. 31, 2019
Effective Income Tax Rate Reconciliation, Amount [Abstract]
Income tax benefit - at statutory tax rate	$ (11,642)	$ (636)	$ (4,823)
Differences in international tax rates	(8,950)	1,755	(1,218)
Nondeductible changes in fair value of contingent consideration	0	988	121
Intercompany asset transfer	0	0	(8,190)
Change in valuation allowances	4,296	4,231	7,379
Nondeductible share-based compensation	645	1,060	1,039
Hospital Products sale	0	(9,328)	0
Unrealized tax benefits	239	(274)	(261)
State and local taxes (net of federal)	60	20	(7)
Change in U.S. tax law	0	(9,124)	0
Nondeductible interest expense	2,173	1,728	982
Orphan drug and R&D tax credit	(1,524)	(2,793)	0
Other	(1,113)	263	(378)
Income tax benefit	$ (15,816)	$ (12,110)	$ (5,356)

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Effective Income Tax Rate Reconciliation, Amount, Orphan Drug and Research And Development Tax Credit

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Amount of reported income tax expense (benefit) in excess of (less than) expected income tax expense (benefit) computed by applying domestic federal statutory income tax rate to pretax income (loss) from continuing operations, attributable to Tax Cuts and Jobs Act.

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Amount of current income tax expense (benefit) and deferred income tax expense (benefit) pertaining to continuing operations.

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